Archived: Glebe Garden

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

At this inspection we found the service remained Good.

Why the service is rated good

The service continues to keep people safe. Recruitment procedures ensured suitable staff were employed to support people and help keep them safe. Risk assessments continued to consider least restrictive options to enable people to continue engaging in activities that enhances their well-being, with care documents supporting the risk assessments.

Medicine management continued to be provided in a safe way. Audits illustrated that people received their medicines in a timely manner and how they wished. Medicines were correctly stored, disposed of and ordered to ensure that people were not without their medicines at any point. A recent pharmacy inspection rated the service highly, with no recommendations or improvements suggested.

Staff training was kept up to date, and a rolling training programme was in place. Staff received frequent supervisions and annual appraisals that allowed reflective practice.

People's needs were assessed initially upon admission, and thereafter reviewed monthly to ensure care was the most appropriate. People were thoroughly involved in their care plan, with no changes being made, until agreement had been received from the person. People were encouraged to personalise their rooms in a style that they preferred, with furnishings that brought a personal touch to their rooms. People were furthermore encouraged to take an active role in the home, by taking personal responsibility for chores, with staff assisting as required.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. This included making decisions about their care, food choice as well as activities. People received exceptionally responsive care. Staff had a thorough understanding of people’s needs and focused on developing people’s skill sets through personalised and responsive care. Family relationships were encouraged, and developed. People were enabled to achieve and attain personal targets and aspirations.

Staff approach remained caring. People were supported by a staff team that knew them well, and ensured they enabled them to maintain their independence, and retain things important to them. Where care support was required, peoples’ dignity and privacy was maintained. People communicated in their preferred way, with records clearly highlighting this.

The service continued to be well-led. There was a clear vision and direction from the senior management team that reflected on staff practice. A new manager had been appointed who was in their induction process. Whilst new to the service, they hoped they could bring their expertise forward to ensure the service continued to progress in the right direction. An open door policy was practiced, whereby staff were able to approach the management team and discuss any issues.

Good community links were created, and the service worked efficiently with visiting health professionals. The service continued to have good governance and reflective practice, ensuring compliance with the regulations.

Further information is in the detailed findings within the report.

Glebe Garden is a care home that offers accommodation for people who require personal care. The service is registered to provide a service for up to four people, with bedrooms located on the first floor. People who live at the service have a primary diagnosis of learning disabilities. The home specialises in working with people to reintegrate them into the community promoting independence and choice.

The home is required to have a registered manager. The registered manager has been in post since March 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff knew how to keep people safe. They were aware of how to report concerns promptly and confidentially. They were familiar with procedures that were clearly outlined in training as well as the service’s own policies and procedures. Comprehensive processes for recruitment of staff were in place to ensure suitable employment and the protection of people against the risk of abuse. Sufficient staffing numbers of trained and experienced staff were provided by the service to ensure the needs of people were met. A rolling training programme was in place, which focused on providing the company’s mandatory training as a minimum standard, with additional supporting training offered in line with best practice meeting the Skills for Care guidelines.

Good caring practice was observed during the inspection. People reported they were content with the support and care provided by the staff. People, and where appropriate their relatives, were involved in the development and reviewing of care plans. These were well documented, detailing individual preferences well and reflective of the person’s needs. Risk assessments specific to the person were contained in files, with guidance on how to manage these risks should they occur.

Responsive practice was observed during the course of the inspection. The service responded to the needs of people, offering them both verbal and emotional support. This lowered anxiety and enabled retention of independence.

Staff and people reconfirmed observations of good communication. The service offered an open door policy, giving people, staff and visitors the opportunity to speak with the registered manager at any time. People told us that they were treated with respect, at all times. Staff always ensured they preserved people’s dignity when working with them.

People were supported by a team of staff who were competency checked prior to being given responsibility for care. Medicines were kept and managed securely. Comprehensive records were kept of guidelines for as required medicines. Audits were completed regularly and showed no medicine errors.

Staff had training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This meant that they understood the importance of informed choice being situation and time specific. All people living at the service had capacity to make decisions for themselves, with the support and guidance of staff.

The quality of the service was monitored by the registered manager. Feedback was obtained from people, visitors, families and stakeholders and used to improve and make any relevant changes to the service. Comprehensive audits were completed that produced reflective action plans that identified timescales for improvement. Evidence illustrated this was actioned promptly.

As part of this inspection we spoke with the three people who use the service, the registered manager, the on duty care worker and the funding authority care managers for two of the people living at the home. We also reviewed records relating to the management of the home which included three care plans, daily care records and other records related to the provision of the service.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

People experienced care and support that was planned and delivered in a way that was intended to ensure people's safety and welfare. One person told us: "They help me look after myself and do things I can do."

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. The layout of the home and grounds and the facilities provided were suitable for the needs of the people living at the home at the time of our inspection.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no DoLS applications had needed to be submitted, proper policies and procedures were in place and the manager was aware of the requirements of the legislation.

Is the service effective?

People we spoke with told us they felt their needs were being met and their care was delivered in the way they preferred. They felt they led decisions on the care and support they received and described how they went through their care plans and signed to say they agreed with its contents. One person told us: "They help me look after myself and do things I can do."

CQC monitors the operation of the Mental Capacity Act 2005 which applies to all services providing care and support for people. Before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes. Staff we spoke with demonstrated a good understanding of people's rights to make their own decisions and their individual responsibilities under the requirements of the Mental Capacity Act 2005.

Is the service caring?

We spoke with the care managers of two of the people living at the home. They were complimentary about the care and support provided to their clients. Comments received from the care managers included: "They are very empowering and encourage my client to develop personal and independence skills.", "The service provided is great." and: "They are a good team and work very well with XX. XX likes the staff and is happy living there."

Is the service responsive?

The provider took account of complaints and comments to improve the service. People we spoke with felt staff listened to what they said and took action if they raised any concerns. One person told us: "If I am not happy about something I just say and it gets sorted out."

Is the service well-led?

The provider had an effective system to regularly assess and monitor the quality of service that people receive. There was evidence that learning from incidents / investigations took place and appropriate changes were implemented if needed.

The home had a service development plan for 2014 in place. The plan identified improvements they wanted to make during the year. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. People we spoke with confirmed they were consulted about issues that affected them and/or the running of the home. One person told us: "They asked me about the garden and also about decorating." another said: "We get to say what we think in meetings with our key workers and the others."

We spoke with two of the people who used the service and they told us they were happy at the home. People had been here for several years and one told us, 'I am happy here at Glebe Gardens'. Another person told us, 'I have lived here about four years. I wanted to move here because it was quieter'.

We found that each person's care and welfare was important to staff and the care plans were being followed. People were enabled and treated with dignity and their consent was requested for care and treatment. They were encouraged and supported to achieve maximum independence.

People were safeguarded from abuse because staff were trained to identify, prevent and to respond to events relating to safeguarding incidents.

The provider regularly assessed and monitored the service and sought the views of people who used the service and other interested parties.

We found people were supported in accordance with their wishes. People told us they liked the staff and living at Glebe Garden.

People who used the service were protected from abuse. Information was shared with staff and the people using the service. Two people told us they felt safe living in the home.

Staff working at the home received appropriate training and undertook further qualifications. The manager told us that some staff had also been able to undertake National Vocational Qualification (NVQ) training in Health and Social Care.

The provider had a complaints process which was shared with people using the service. People told us about concerns they had raised and how they were dealt with promptly.